SPRAINS AND STRAINS
What Is the Difference Between a Sprain and a Strain?
A sprain is an injury to a ligament--a stretching or a tearing. One or more ligaments can be injured during a sprain. The severity of the injury will depend on the extent of injury to a single ligament (whether the tear is partial or complete) and the number of ligaments involved.
A strain is an injury to either a muscle or a tendon. Depending on the severity of the injury, a strain may be a simple overstretch of the muscle or tendon, or it can result in a partial or complete tear.
What Causes a Sprain?
A sprain can result from a fall, a sudden twist, or a blow to the body that forces a joint out of its normal position. This results in an overstretch or tear of the ligament supporting that joint. Typically, sprains occur when people fall and land on an outstretched arm, slide into base, land on the side of their foot, or twist a knee with the foot planted firmly on the ground.
Where Do Sprains Usually Occur?
Although sprains can occur in both the upper and lower parts
of the body, the most common site is the ankle. Ankle sprains
are the most common injury in the United States and often occur
during sports or recreational activities. Approximately 1 million
ankle injuries occur each year, and 85 percent of them are sprains.
What Are the Signs and Symptoms of a Sprain?
The usual signs and symptoms include pain, swelling, bruising,
and loss of the ability to move and use the joint (called functional
ability). However, these signs and symptoms can vary in intensity,
depending on the severity of the sprain. Sometimes people feel
a pop or tear when the injury happens.
What Causes a Strain?
A strain is caused by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is caused by trauma or an injury such as a blow to the body; it can also be caused by improperly lifting heavy objects or overstressing the muscles. Chronic strains are usually the result of overuse--prolonged, repetitive movement of the muscles and tendons.
Where Do Strains Usually Occur?
Two common sites for a strain are the back and the hamstring muscle (located in the back of the thigh). Contact sports such as soccer, football, hockey, boxing, and wrestling put people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains sometimes occur in people who participate in racquet sports, throwing, and contact sports.
What Are the Signs and Symptoms of a Strain?
Typically, people with a strain experience pain, muscle spasm, and muscle weakness. They can also have localized swelling, cramping, or inflammation and, with a minor or moderate strain, usually some loss of muscle function. Patients typically have pain in the injured area and general weakness of the muscle when they attempt to move it. Severe strains that partially or completely tear the muscle or tendon are often very painful and disabling.
How Are Sprains and Strains Treated?
Treatment for sprains and strains is similar and can be thought of as having two stages. The goal during the first stage is to reduce swelling and pain. At this stage, doctors usually advise patients to follow a formula of rest, ice, compression, and elevation (RICE) for the first 24 to 48 hours after the injury (see the box below). The doctor may also recommend an over-the-counter or prescription non-steroidal anti-inflammatory drug, such as aspirin or ibuprofen, to help decrease pain and inflammation.
For people with a moderate or severe sprain, particularly of the ankle, a hard cast may be applied. Severe sprains and strains may require surgery to repair the torn ligaments, muscle, or tendons. Surgery is usually performed by an orthopedic surgeon.
It is important that moderate and severe sprains and strains be evaluated by a doctor to allow prompt, appropriate treatment to begin.
The second stage of treating a sprain or strain is rehabilitation,
whose overall goal is to improve the condition of the injured
part and restore its function. The health care provider will
prescribe an exercise program designed to prevent stiffness,
improve range of motion, and restore the joint's normal flexibility
and strength. Some patients may need physical therapy during
this stage.
Prevention
No one is immune to sprains and strains, but here are some tips developed by the American Academy of Orthopaedic Surgeons to help reduce your injury risk:- Participate in a conditioning program to build muscle strength
- Do stretching exercises daily
- Always wear properly fitting shoes
- Nourish your muscles by eating a well-balanced diet
- Warm up before any sports activity, including practice
- Use or wear protective equipment appropriate for that sport